| NPI | 1851526974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DC MD041971) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0073511) |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2014-08-05 |